Understanding the Link Between Leaky Gut and Dermatitis

The connection between gut health and skin conditions has drawn increased scientific interest, with research spotlighting the “gut-skin axis.” This complex relationship sheds light on why conditions like dermatitis may be worsened by imbalances in the gut, often linked to a condition known as leaky gut, or increased intestinal permeability. Understanding this connection can empower those with dermatitis to explore nutrition and lifestyle strategies that may relieve their symptoms.

This article covers:

• What is leaky gut?
• How does leaky gut affect skin health?
  • Systemic inflammation
  • Microbial imbalance
  • Immune system over-reactivity
• How leaky gut impacts immune balance in dermatitis
• Links Between Dysbiosis and Eczema
• The Gut-Liver-Skin Axis
• The Impact of Nutrient Deficiencies on Gut and Skin Health
• 5 Nutrition Tips to Support Gut Health and Manage Dermatitis
• Additional Lifestyle Practices to Consider

What is Leaky Gut?

​Leaky gut refers to a state where the lining of the small intestine becomes more permeable than it should be. In a healthy digestive system, the gut lining serves as a selective barrier, regulating what enters the bloodstream. However, when this barrier is compromised, larger particles—such as undigested food particles, toxins, and bacteria—can pass through, triggering an immune response. This constant immune activation can lead to chronic, low-grade inflammation, which has been associated with a variety of health issues, including autoimmune conditions and inflammatory skin diseases like dermatitis.

How Does Leaky Gut Affect Skin Health?

​Leaky gut can contribute to skin inflammation and worsen dermatitis through several mechanisms:

Systemic Inflammation: 

​When particles that shouldn’t be in the bloodstream cross over, it activates the immune system. This chronic, low-grade inflammation can affect various parts of the body, including the skin. For those with dermatitis, this inflammatory response can increase skin irritation and itching.

One mechanism by which leaky gut impacts dermatitis is through T-helper cells, a type of immune cell that becomes overactive in response to foreign particles. This overactivity can lead to increased skin inflammation, as Th cells promote the release of inflammatory compounds. Individuals with dermatitis often show a skewed Th cell response, and leaky gut may exacerbate this immune imbalance, leading to more intense or frequent skin flare-ups.

Microbial Imbalance: 

​The gut is home to a large population of bacteria that help regulate immune health. A leaky gut often goes hand in hand with a microbial imbalance, known as dysbiosis. Studies show that people with dermatitis, like eczema, often have different gut bacteria compositions than those without skin issues, suggesting a connection between gut imbalance and the severity of skin conditions.
 
The gut microbiome, or the collection of trillions of bacteria living in the gut, plays a critical role in maintaining gut health and integrity. A balanced microbiome can help regulate immune responses and support a healthy gut barrier. However, in individuals with leaky gut, there is often an imbalance in gut bacteria, a condition known as dysbiosis. This imbalance may result from dietary choices, antibiotic use, or stress, and it can lead to increased gut permeability and a higher likelihood of immune dysregulation.

Immune System Overactivity: 

​With a more permeable gut, the immune system is exposed to foreign particles more often, leading to heightened immune responses. In atopic dermatitis, a common form of dermatitis, this overactive immune system plays a large role in flare-ups and worsening symptoms.
 
For individuals with dermatitis, leaky gut can influence the skin by shifting the immune system into a more reactive state. This heightened immune response is particularly relevant in dermatitis, which involves an imbalance of immune activity that leads to skin inflammation, dryness, and irritation. When undigested food particles or pathogens pass through the leaky gut wall, they are flagged by the immune system as foreign invaders. The result is a chronic inflammatory reaction that can affect the skin, worsening dermatitis symptoms.

Links Between Dysbiosis and Eczema

​Studies indicate that people with eczema, a common form of dermatitis, often have less diversity in their gut microbiome compared to those without skin issues. This reduced diversity may weaken the gut lining and increase inflammation. Some research even suggests that promoting a healthy gut microbiome through probiotics and prebiotics can help regulate immune responses and reduce the severity of eczema symptoms, particularly in young children. (1–3)

The Gut-Liver-Skin Axis

​Recent studies propose that the liver also plays a role in this connection, as it detoxifies compounds that have entered the bloodstream from the gut. When leaky gut allows more toxins to enter the bloodstream, it can overload the liver, leading to increased inflammation that ultimately affects the skin. This is sometimes referred to as the “gut-liver-skin axis,” and it may further explain how gut health influences skin conditions like dermatitis.

The Impact of Nutrient Deficiencies on Gut and Skin Health

Nutrient deficiencies can worsen leaky gut by weakening the gut barrier, making the skin more susceptible to inflammation. Here’s a closer look at a few key nutrients that play an important role in maintaining a healthy gut and resilient skin:

1. Vitamin D: Known for its role in immune modulation, vitamin D is also essential for maintaining gut barrier integrity. Low levels of vitamin D are associated with increased gut permeability and have been linked to a higher risk of developing autoimmune and inflammatory conditions, including dermatitis.
2. Vitamin A: This fat-soluble vitamin is crucial for maintaining mucosal integrity in both the gut and the skin. Vitamin A deficiency can lead to a compromised gut lining and weaken skin resilience. Dietary sources include liver, carrots, and leafy greens.
3. Zinc: Essential for immune function and tissue repair, zinc helps maintain the structural integrity of the gut lining. Zinc deficiency has been linked to increased gut permeability and inflammation, making it a crucial nutrient for individuals with dermatitis. Zinc-rich foods include pumpkin seeds, chickpeas, and seafood.
4. Omega-3 Fatty Acids: Found in fish and flaxseeds, omega-3 fatty acids help reduce inflammation throughout the body. Studies show that omega-3s may improve skin hydration and barrier function, making them a valuable addition for those with inflammatory skin conditions.
5. L-glutamine: This amino acid is a primary fuel source for the cells lining the gut, known as enterocytes, and plays a role in strengthening the gut barrier. L-glutamine has been studied for its ability to reduce gut permeability, which can benefit those with leaky gut and skin inflammation.

5 Nutrition Tips to Support Gut Health and Manage Dermatitis

Adding to the above nutrient highlights, here are five practical nutrition tips to further support gut health:

1. Start with a Balanced Diet: A diet rich in whole foods, including vegetables, fruits, lean proteins, and healthy fats, can help support a healthy gut microbiome. Fibre from whole foods feeds beneficial gut bacteria, which helps maintain gut integrity and may reduce systemic inflammation.
2. Incorporate Fermented Foods: Fermented foods such as kefir, kimchi, and sauerkraut contain live cultures that introduce beneficial bacteria to the gut, supporting a balanced microbiome. A diverse microbiome can help regulate immune responses and strengthen the gut lining, which may reduce dermatitis symptoms.
3. Add Bone Broth: Bone broth is rich in collagen and amino acids like glycine and glutamine, which can help repair the gut lining. Including bone broth in your diet can support gut health, potentially reducing inflammation that impacts the skin.
4. Reduce Alcohol and Caffeine: Excessive alcohol and caffeine intake can irritate the gut lining, increasing permeability. Reducing or moderating intake of these substances can support a healthier gut environment and potentially improve skin conditions like dermatitis.
5. Ensure Sufficient Hydration: Adequate hydration is essential for maintaining mucosal barriers and promoting skin hydration. Drinking enough water each day supports the body’s ability to flush out toxins, and staying hydrated can promote gut and skin health.

Additional Lifestyle Practices to Consider

​In addition to diet, managing stress, getting sufficient sleep, and limiting NSAID and antibiotic use can all help maintain gut integrity and reduce inflammation. Chronic stress, for instance, increases cortisol levels, which can weaken the gut barrier over time. Similarly, restorative sleep supports immune health and skin repair, making it an essential component of a gut-skin-friendly lifestyle.
 
The connection between leaky gut and dermatitis reinforces the idea that good gut health is foundational to skin health. By focusing on gut-supportive nutrition, managing stress, and incorporating lifestyle changes, those with dermatitis may find relief from symptoms and improve skin resilience.
 
Working with a Registered Nutritional Therapist can provide personalised guidance for integrating these practices and ensuring nutrient needs are met to support both gut and skin health

References

1.  Nekrasova AI, Kalashnikova IG, Bobrova MM, Korobeinikova A V., Bakoev SY, Ashniev GA, et al. Characteristics of the Gut Microbiota in Regard to Atopic Dermatitis and Food Allergies of Children. Biomedicines. 2024 Mar 1;12(3).
2.  Bjerre RD, Holm JB, Palleja A, Sølberg J, Skov L, Johansen JD. Skin dysbiosis in the microbiome in atopic dermatitis is site-specific and involves bacteria, fungus and virus. BMC Microbiol. 2021 Dec 1;21(1).
3. Pachacama López AF, Tapia Portilla MF, Moreno-Piedrahíta Hernández F, Palacios-Álvarez S. Probiotics to Reduce the Severity of Atopic Dermatitis in Pediatric Patients: A Systematic Review and Meta-Analysis. Actas Dermosifiliogr. 2021 Nov 1;112(10):881–90.